Birth Preferences?

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Clarkton's picture
Joined: 01/07/08
Posts: 1972
Birth Preferences?

I've never done an official "birth plan" before. I'm really thinking of putting a very few bullet points on a piece of paper to give my nurse this time. Also, some very basic reminders for DH. I don't really have many things that I'm a big stickler about but I do have some specific things I would like to go differently this time.

So here's what I'm planning to write down and give the hospital staff:

- Plan to have a natural L&D; not wanting an epi or other pain meds. A local is fine if need some stitches post delivery.

- Would like to labor down once complete until I feel the urge to push (not start pushing just b/c I'm 10 cm)

- Try different pushing positions according to how I feel

- Delay cord cutting (like at least 3 to 5 minutes) and hopefully have baby placed on me immediately

So that's it...my goal here is few interventions during laboring, just let me do my thing. With the second and third items I'm trying to avoid tearing this time and although the pushing phase has gone very quickly for me in the past, I've never felt the urge to push and have just actively worked to push baby out while laying flat on my back. I'm thinking if I wait for the urge and get in better position then maybe it won't be as much work and I can control the exit better so I don't tear. I really have no clue on this but there is that saying about how doing the same thing and expecting different results is the definition of insanity. So just trying something different. Wink

Anyone else preparing or did prepare any "birth plan"? Do you have any thoughts about what you are expecting / hoping for with this birth?

sandraleigh's picture
Joined: 11/23/06
Posts: 2672

Those look like great, easy to follow, simple points to have on a paper. It will be handy to have just so they know your preferences.

I agree about people are often encouraged to push just because they are 10 cm. With my #3, I was 10 cm but he was still at a -1 station. Thankfully they recommended waiting for him to move down on his own some more before I started pushing, which doctors don't often do. I waited another hour until he was at +2 station and started feeling more of an urge.

MJDttc's picture
Joined: 08/12/12
Posts: 1118

Since the standard is the birthcenter is most of my list, I just have a few silly requests. Like keeping the room as dark as possible for most of the time, and keeping people quite though I may wind up wearing my headphones for a while. My sister wants me to make her a plan-ish of sorts so she knows what sorts of things I want and don't want.

Joined: 03/07/05
Posts: 1595

Sounds good. Since I have had a midwife for my last 4 births, I've never had anyone telling me to push, and honestly, I haven't really pushed at all with my last 4 babies!! There have been a couple contractions here and there where I did bear down slightly, but I have NEVER felt the urge to actively push. My body still shoots those babies out within about 15 minutes of having my water broken though (once I'm 9-10 cm). Yes, I would say your body will likely do a fine job of laboring down the baby all on it's own. If you do get the urge to push, then by all means push, but in not, just let your body do its thing. ETA: Oh, and I did not tear with any of my last 4 deliveries either!

Heatherbella's picture
Joined: 02/14/05
Posts: 4169

Sounds great!!!

One thing I'm putting on mine is to not OFFER pain meds...but wait for me to ask. That's key. A friend said she had to refuse an epi like TEN times! WOAH!

I've read so many positive things about waiting to push until you have the urge. I hope you are able to do that! It definitely helps with tearing less. Also, if you can not be flat on your back, that should help too. Can you squat to push?

Joined: 03/07/05
Posts: 1595

Oh, and another thing about pushing. It may not be the norm, but I actually PREFER to be on my back or a little on my side/back to push. When I'm sitting straight up or squatting there is just WAY too much pressure on my cervix. Some women may need the help gravity provides. I do not, and it's way too intense for me! Don't be afraid to do what feels right for you, whether that's on your back, or squatting, or something else. Just do what works!!

Clarkton's picture
Joined: 01/07/08
Posts: 1972

Heather, very good question! Yes, it's supposed to be a good pushing position that increases the pelvic outlet size but I can't for the life of me envision getting into a squatting position and being comfortable pushing that way. I think hands and knees makes a lot more sense to me just thinking about it. Or also perhaps standing and leaning over the bed. I wonder how the staff will deal with that...I'm sure it's not something they are used to. My OB says I can do whatever I want but he's also never actually attended me for delivery Wink

Laurie, good point and advice. Smile I wonder about this b/c I feel like I may be more comfortable just laying down; back or side. But I want DH and/or my nurse (if I'm lucky) to help me try things, if I feel like it, when I get to that point to see what does really work for me. My gut feeling is laboring down and not working to push baby out will be the really effective part to the end of not tearing.

Heatherbella's picture
Joined: 02/14/05
Posts: 4169

Ya, I'm no expert at the whole thing...it's just based on things I've read. LOL. And like Laurie says, what works for one, might not work for another.

I'm pretty sure my hubby and doula will have to help me get into positions. Something like this looks good for squatting...having the support would be good.

http://givingbirthwithconfidence.org/files/2011/03/lamaze_position04.jpg

Joined: 10/12/04
Posts: 961

I've always felt just right with the amount of incline the hospital bed has. It's just the right amount of gravity for me.

I don't have a ton of preferences. Mostly, I don't like being bossed around. Don't tell me to push. Don't tell me how to breathe. In fact, don't even look at me unless I tell you to. Smile

Past that, I dot feel too strongly about anything. If I want pain meds, I will tell you. Don't ask me. That's the only other one.

akpufa's picture
Joined: 01/31/08
Posts: 3078

Great list. I agree 100% with laboring down also. I had to wait for my doc to make the drive to the hospital and in that time could feel him moving down from probably -1/0 to +2. It was hard towards the end to not push but it paid off huge when I got to push and felt for the first time in all 3 births that I could actually push productively and it only took a few.

As far as what I had "planned" I had requested skin to skin after the birth but wasn't able to do that because of him swallowing a lot of blood on the way out. I wasn't planning on delayed cord clamping but in my case it wouldn't have been the best choice because they needed to get him sucked out and monitored ASAP once he was out . Point being, I think it's great to have specifics you'd like to have during your birth but keep an open mind for situations that may come up. I was mildly bummed that I didn't get to have that skin to skin moment but I did later and at the time the most important thing was to make sure he was taken care of. I just know people who feel they've "failed" if they don't get every single thing they hope for when we can never predict exactly how a birth will go.

Heatherbella's picture
Joined: 02/14/05
Posts: 4169

What exactly do you mean by 'laboring down'? Do you mean not strapped to a bed?

I hear ya Ashley. I've gone into both births having wishes but not NEEDS. I know things can change quickly and in the heat of the moment you need to do what's right for everyone in the given situation. That's why I went from 'hoping for no meds' to a 'planned c-section' with DD so quickly. Although I didn't regret my decision at the time, now I sort of wish I hadn't had to do it that way. Life goes on...

akpufa's picture
Joined: 01/31/08
Posts: 3078

"Heatherbella" wrote:

What exactly do you mean by 'laboring down'? Do you mean not strapped to a bed?

No like once you're 10 cm, your baby might not necessarily be dropped all the way down as far as s/he can go before pushing which leads to a lot of unnecessary pushing when your body and baby could make a lot of that progress themselves. I labored down in bed (epidural so couldn't walk if I wanted to)

Heatherbella's picture
Joined: 02/14/05
Posts: 4169

Oooh, ok, so like don't push until you feel the urge?

quonsetmom's picture
Joined: 10/10/12
Posts: 1559

I had a plan but only worried abt the big things. It went as best it could for us minus the bad epi. I think it's great to write down the most important parts Smile

Joined: 10/12/04
Posts: 961

I have always felt an intense urge to push even with an epidural. With both kids the nurse had just said I was only 4cm and ten minutes later I was begging to push. Sure enough, I had jumped to 10.

Clarkton's picture
Joined: 01/07/08
Posts: 1972

"Heatherbella" wrote:

Oooh, ok, so like don't push until you feel the urge?

I only recently came across the term in my random reading on the internet. But yes, that was where my mind went b/c it fit with what I had been thinking.

Both times they have told me I'm complete, fully dilated, rushed in the doc for delivery and started prompting me to push. I hear ladies talk about experiencing an urge to push and I never have. I have since wondered if I waited and let the contractions do a little more work if I would reach a point where I have an urge and maybe also if I didn't actively work as much with pushing it wouldn't be so fast or forceful allowing things to stretch and maybe not tear. Yes, I'm a bit obsessed with the not tearing Wink

Heatherbella's picture
Joined: 02/14/05
Posts: 4169

I think you've got the right idea. Go with it! I've heard that not tearing vs. tearing is a WHOLE different world. Of course, I had every intervention with a c-section so although tearing isn't my first choice, I'd think it's better than a c-section. Blum 3 That said, I'm going for none of the above. Blum 3

Joined: 08/25/10
Posts: 385

You can also have them not check you towards the end there. With DD, the doc came in and saw that I was involuntarily pushing, and asked me if I was feeling the urge - I didn't really know what I was doing, I just couldn't stop myself from pushing lightly with each contraction. Then she checked me and I was at 10cm. She didn't encourage lots of active pushing, which was good since S took about an hour of lightly pushing to come out.

This time around, they also didn't check me. Just asked me to tell them when I felt the urge to push. And I was VERY aware that when you do feel the urge, you should push in small bursts (like 5-6 seconds) to help ease the baby down and avoid tearing. The first three contractions where I felt the urge I just let my stomach lightly push. Then by the fourth, the urge was really strong so I pushed for 5 second intervals during the contraction (yes I counted in my head to make sure I didn't go too long since you really want to get the baby out!) Matan came out in about 3 pushes, and I had no tearing whatsoever. With S I had no tears, but a few scratches which were bad enough imo.

Also, I have found that by the time I'm at the urge to push stage, I really don't want to move at all. With S I had been lying on my side, so I stayed there until it was time to deliver and I turned slightly onto my back/side. This time I had been laboring with my hands on the bed and my knees on the floor (much more comfortable than squatting) and I honestly didn't feel like I could move onto the bed if I wanted to, so I just gave birth in that position which worked out really great.

When you feel like you're about to crap in your pants and your stomach won't stop making pushes regardless of what you do - then you're ready to push! I agree that you should be adamant about that to have the birth you want, and avoid tearing.

Clarkton's picture
Joined: 01/07/08
Posts: 1972

Great info Adina! I think leaning on the bed like you describe sounds like a good position...makes sense to me that would be fairly natural.

Heatherbella's picture
Joined: 02/14/05
Posts: 4169

I agree! Great info Adina! I can only hope things will go that smoothly for me! Biggrin